Abstract:A case management program is designed so that the nurses could work with any client within the health system, regardless of the diagnosis or provider. A variety of challenges surfaced: maintaining visibility within a large health care system; working with varied approaches to client care issues; and being clinically knowledgeable in the variety of chronic illnesses. Hospital admissions, physician and emergency department visits and costs are measured after establishing a nurse case management program.[Nurs Manags 1998:29(1):24–25]